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| Plan Name | COURTYARD POST ACUTE MEDICAL PLAN |
| Plan identification number | 503 |
| 401k Plan Type | Welfare Benefit |
| Plan Features/Benefits |
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| Company Name: | COURTYARD POST ACUTE LLC |
| Employer identification number (EIN): | 862582686 |
| NAIC Classification: | 623000 |
| NAIC Description: | Nursing and Residential Care Facilities |
| Plan id# | Filing Submission Date | Name of Administrator | Date Administrator Signed | Name of Company Sponsor | Date Sponsor Signed |
|---|---|---|---|---|---|
| 503 | 2021-07-01 | COURTNEY SMALL | 2023-01-30 |
| 2021: COURTYARD POST ACUTE MEDICAL PLAN 2021 form 5500 responses | ||
|---|---|---|
| 2021-07-01 | Type of plan entity | Single employer plan |
| 2021-07-01 | First time form 5500 has been submitted | Yes |
| 2021-07-01 | This submission is the final filing | Yes |
| 2021-07-01 | Plan funding arrangement – Insurance | Yes |
| 2021-07-01 | Plan benefit arrangement – Insurance | Yes |
| KAISER FOUNDATION HEALTH PLAN OF HAWAII (National Association of Insurance Commissioners NAIC id number: 00000 ) | |
| Policy contract number | 235367 |
| Policy instance | 1 |
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